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CMS RVU26D · Effective 2026-10-01

46270 in Delaware

Office / nonfacility

$592.46

Base rate per service

Facility setting

$403.04

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Colorectal surgery

About 46270: Subcutaneous anal fistula surgery

Reports surgical treatment of a superficial anal fistula confined to the subcutaneous tissue, without a deeper tract involving the sphincter muscles.

This service treats a superficial anal fistula whose tract is confined to tissue beneath the skin around the anus. The surgeon opens or excises the tract to treat the fistula. Colorectal and general surgeons typically perform the procedure in an operating room or ambulatory surgery setting. The operative note should establish the tract’s course and its relationship to the sphincter muscles.

Select this code by the documented anatomy and extent of the fistula, not simply by the fact that a fistula was treated. A tract involving the sphincter or a complex course points to a different code. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.

CMS billing rules for 46270

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU4.80 · 27%
  • Practice expense (office) RVU12.17 · 68%
  • Malpractice RVU0.99 · 6%

1.5K

Medicare services in 2024 · #2668 by national volume

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

46270 compared with similar codes

Office rates for Delaware, from the same CMS release.

46275

Fistula surgery

Intersphincteric tract

$623.13

Use 46270 for a tract limited to subcutaneous tissue; 46275 is for an intersphincteric tract.

46280

Anal fistula surgery

Complex sphincter-crossing tract

No office rate

46270 identifies a subcutaneous tract, while 46280 is for a complex fistula. The operative findings determine which anatomy is documented.

46285

Anal fistula surgery

Staged treatment

$623.43

46285 describes staged fistula treatment. 46270 is selected for a subcutaneous fistula treated surgically, not because treatment is staged.

The same code, a different location

How does Delaware compare?

46270 across payment areas

Same release and payment basis · bars start at $0

  1. Delaware · This locality

    $592.46

  2. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $669.73

    $77.27 higher than Delaware

  3. Dc + Md/Va Suburbs

    $684.63

    $92.17 higher than Delaware

  4. Miami

    $667.11

    $74.65 higher than Delaware

  5. Chicago

    $645.86

    $53.40 higher than Delaware

  6. Manhattan

    $695.37

    $102.91 higher than Delaware

  7. Alaska*

    $691.62

    $99.16 higher than Delaware

Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 46270 ranges from $526.53 in Arkansas to $781.84 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Alabama

    Alabama · 46270

    Office

    $534.72

    Facility

    $366.96

    $57.74 lower than Delaware for the office setting.

  • Arkansas

    Arkansas · 46270

    Office

    $526.53

    Facility

    $361.84

    $65.93 lower than Delaware for the office setting.

  • Arizona

    Arizona · 46270

    Office

    $582.52

    Facility

    $396.74

    $9.94 lower than Delaware for the office setting.

  • Bakersfield

    California · 46270

    Office

    $629.02

    Facility

    $418.89

    $36.56 higher than Delaware for the office setting.

  • Chico

    California · 46270

    Office

    $626.29

    Facility

    $416.16

    $33.83 higher than Delaware for the office setting.

  • El Centro

    California · 46270

    Office

    $626.45

    Facility

    $416.32

    $33.99 higher than Delaware for the office setting.

  • Fresno

    California · 46270

    Office

    $626.29

    Facility

    $416.16

    $33.83 higher than Delaware for the office setting.

  • Hanford-Corcoran

    California · 46270

    Office

    $626.29

    Facility

    $416.16

    $33.83 higher than Delaware for the office setting.

  • Madera

    California · 46270

    Office

    $626.29

    Facility

    $416.16

    $33.83 higher than Delaware for the office setting.

  • Merced

    California · 46270

    Office

    $626.29

    Facility

    $416.16

    $33.83 higher than Delaware for the office setting.

  • Modesto

    California · 46270

    Office

    $626.29

    Facility

    $416.16

    $33.83 higher than Delaware for the office setting.

  • Napa

    California · 46270

    Office

    $722.98

    Facility

    $470.29

    $130.52 higher than Delaware for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 46270

    Office

    $665.88

    Facility

    $439.27

    $73.42 higher than Delaware for the office setting.

  • Redding

    California · 46270

    Office

    $626.29

    Facility

    $416.16

    $33.83 higher than Delaware for the office setting.

  • Rest Of California

    California · 46270

    Office

    $626.29

    Facility

    $416.16

    $33.83 higher than Delaware for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 46270

    Office

    $636.93

    Facility

    $426.80

    $44.47 higher than Delaware for the office setting.

  • Sacramento-Roseville-Folsom

    California · 46270

    Office

    $656.57

    Facility

    $433.59

    $64.11 higher than Delaware for the office setting.

  • Salinas

    California · 46270

    Office

    $654.14

    Facility

    $431.93

    $61.68 higher than Delaware for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 46270

    Office

    $669.22

    Facility

    $439.92

    $76.76 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 46270

    Office

    $763.88

    Facility

    $493.56

    $171.42 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 46270

    Office

    $762.76

    Facility

    $492.43

    $170.30 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 46270

    Office

    $781.84

    Facility

    $505.38

    $189.38 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 46270

    Office

    $777.24

    Facility

    $500.78

    $184.78 higher than Delaware for the office setting.

  • San Luis Obispo-Paso Robles

    California · 46270

    Office

    $643.76

    Facility

    $425.39

    $51.30 higher than Delaware for the office setting.

  • Santa Cruz-Watsonville

    California · 46270

    Office

    $675.30

    Facility

    $442.36

    $82.84 higher than Delaware for the office setting.

  • Santa Maria-Santa Barbara

    California · 46270

    Office

    $656.50

    Facility

    $432.96

    $64.04 higher than Delaware for the office setting.

  • Santa Rosa-Petaluma

    California · 46270

    Office

    $682.03

    Facility

    $446.59

    $89.57 higher than Delaware for the office setting.

  • Stockton

    California · 46270

    Office

    $626.29

    Facility

    $416.16

    $33.83 higher than Delaware for the office setting.

  • Vallejo

    California · 46270

    Office

    $721.35

    Facility

    $468.67

    $128.89 higher than Delaware for the office setting.

  • Visalia

    California · 46270

    Office

    $626.29

    Facility

    $416.16

    $33.83 higher than Delaware for the office setting.

  • Yuba City

    California · 46270

    Office

    $626.29

    Facility

    $416.16

    $33.83 higher than Delaware for the office setting.

  • Colorado

    Colorado · 46270

    Office

    $620.58

    Facility

    $416.59

    $28.12 higher than Delaware for the office setting.

  • Connecticut

    Connecticut · 46270

    Office

    $641.33

    Facility

    $434.85

    $48.87 higher than Delaware for the office setting.

  • Fort Lauderdale

    Florida · 46270

    Office

    $631.88

    Facility

    $437.67

    $39.42 higher than Delaware for the office setting.

  • Rest Of Florida

    Florida · 46270

    Office

    $598.63

    Facility

    $415.34

    $6.17 higher than Delaware for the office setting.

  • Atlanta

    Georgia · 46270

    Office

    $613.51

    Facility

    $418.72

    $21.05 higher than Delaware for the office setting.

  • Rest Of Georgia

    Georgia · 46270

    Office

    $562.33

    Facility

    $391.31

    $30.13 lower than Delaware for the office setting.

  • Hawaii, Guam

    Hawaii · 46270

    Office

    $641.65

    Facility

    $423.66

    $49.19 higher than Delaware for the office setting.

  • Iowa

    Iowa · 46270

    Office

    $545.39

    Facility

    $369.96

    $47.07 lower than Delaware for the office setting.

  • Idaho

    Idaho · 46270

    Office

    $549.93

    Facility

    $373.55

    $42.53 lower than Delaware for the office setting.

  • East St. Louis

    Illinois · 46270

    Office

    $600.89

    Facility

    $424.51

    $8.43 higher than Delaware for the office setting.

  • Rest Of Illinois

    Illinois · 46270

    Office

    $583.13

    Facility

    $408.09

    $9.33 lower than Delaware for the office setting.

  • Suburban Chicago

    Illinois · 46270

    Office

    $637.51

    Facility

    $440.61

    $45.05 higher than Delaware for the office setting.

  • Indiana

    Indiana · 46270

    Office

    $553.21

    Facility

    $375.48

    $39.25 lower than Delaware for the office setting.

  • Kansas

    Kansas · 46270

    Office

    $544.46

    Facility

    $371.14

    $48.00 lower than Delaware for the office setting.

  • Kentucky

    Kentucky · 46270

    Office

    $551.95

    Facility

    $381.51

    $40.51 lower than Delaware for the office setting.

  • New Orleans

    Louisiana · 46270

    Office

    $580.39

    Facility

    $399.98

    $12.07 lower than Delaware for the office setting.

  • Rest Of Louisiana

    Louisiana · 46270

    Office

    $551.75

    Facility

    $382.07

    $40.71 lower than Delaware for the office setting.

  • Metropolitan Boston

    Massachusetts · 46270

    Office

    $681.67

    Facility

    $452.76

    $89.21 higher than Delaware for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 46270

    Office

    $617.28

    Facility

    $415.39

    $24.82 higher than Delaware for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 46270

    Office

    $639.96

    Facility

    $434.24

    $47.50 higher than Delaware for the office setting.

  • Rest Of Maryland

    Maryland · 46270

    Office

    $603.65

    Facility

    $409.63

    $11.19 higher than Delaware for the office setting.

  • Rest Of Maine

    Maine · 46270

    Office

    $554.86

    Facility

    $378.48

    $37.60 lower than Delaware for the office setting.

  • Southern Maine

    Maine · 46270

    Office

    $584.02

    Facility

    $394.02

    $8.44 lower than Delaware for the office setting.

  • Detroit

    Michigan · 46270

    Office

    $608.34

    Facility

    $423.33

    $15.88 higher than Delaware for the office setting.

  • Rest Of Michigan

    Michigan · 46270

    Office

    $568.78

    Facility

    $393.74

    $23.68 lower than Delaware for the office setting.

  • Minnesota

    Minnesota · 46270

    Office

    $588.39

    Facility

    $391.11

    $4.07 lower than Delaware for the office setting.

  • Metropolitan Kansas City

    Missouri · 46270

    Office

    $574.32

    Facility

    $394.30

    $18.14 lower than Delaware for the office setting.

  • Metropolitan St. Louis

    Missouri · 46270

    Office

    $580.43

    Facility

    $397.92

    $12.03 lower than Delaware for the office setting.

  • Rest Of Missouri

    Missouri · 46270

    Office

    $542.92

    Facility

    $377.66

    $49.54 lower than Delaware for the office setting.

  • Mississippi

    Mississippi · 46270

    Office

    $534.75

    Facility

    $369.68

    $57.71 lower than Delaware for the office setting.

  • Montana**

    Montana · 46270

    Office

    $599.81

    Facility

    $408.09

    $7.35 higher than Delaware for the office setting.

  • North Carolina

    North Carolina · 46270

    Office

    $560.71

    Facility

    $381.83

    $31.75 lower than Delaware for the office setting.

  • North Dakota**

    North Dakota · 46270

    Office

    $580.24

    Facility

    $388.52

    $12.22 lower than Delaware for the office setting.

  • Nebraska

    Nebraska · 46270

    Office

    $548.01

    Facility

    $371.05

    $44.45 lower than Delaware for the office setting.

  • New Hampshire

    New Hampshire · 46270

    Office

    $612.41

    Facility

    $412.83

    $19.95 higher than Delaware for the office setting.

  • Northern Nj

    New Jersey · 46270

    Office

    $677.27

    Facility

    $454.87

    $84.81 higher than Delaware for the office setting.

  • Rest Of New Jersey

    New Jersey · 46270

    Office

    $646.90

    Facility

    $437.54

    $54.44 higher than Delaware for the office setting.

  • New Mexico

    New Mexico · 46270

    Office

    $572.79

    Facility

    $396.98

    $19.67 lower than Delaware for the office setting.

  • Nevada**

    Nevada · 46270

    Office

    $594.76

    Facility

    $402.85

    $2.30 higher than Delaware for the office setting.

  • Nyc Suburbs/Long Island

    New York · 46270

    Office

    $715.31

    Facility

    $487.35

    $122.85 higher than Delaware for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 46270

    Office

    $652.66

    Facility

    $442.72

    $60.20 higher than Delaware for the office setting.

  • Queens

    New York · 46270

    Office

    $698.74

    Facility

    $472.12

    $106.28 higher than Delaware for the office setting.

  • Rest Of New York

    New York · 46270

    Office

    $569.73

    Facility

    $387.60

    $22.73 lower than Delaware for the office setting.

  • Ohio

    Ohio · 46270

    Office

    $564.78

    Facility

    $389.74

    $27.68 lower than Delaware for the office setting.

  • Oklahoma

    Oklahoma · 46270

    Office

    $549.01

    Facility

    $377.80

    $43.45 lower than Delaware for the office setting.

  • Portland

    Oregon · 46270

    Office

    $639.10

    Facility

    $426.10

    $46.64 higher than Delaware for the office setting.

  • Rest Of Oregon

    Oregon · 46270

    Office

    $588.43

    Facility

    $397.48

    $4.03 lower than Delaware for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 46270

    Office

    $625.81

    Facility

    $426.23

    $33.35 higher than Delaware for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 46270

    Office

    $564.73

    Facility

    $388.73

    $27.73 lower than Delaware for the office setting.

  • Puerto Rico

    Puerto Rico · 46270

    Office

    $603.86

    Facility

    $410.03

    $11.40 higher than Delaware for the office setting.

  • Rhode Island

    Rhode Island · 46270

    Office

    $612.77

    Facility

    $414.72

    $20.31 higher than Delaware for the office setting.

  • South Carolina

    South Carolina · 46270

    Office

    $564.03

    Facility

    $386.88

    $28.43 lower than Delaware for the office setting.

  • South Dakota**

    South Dakota · 46270

    Office

    $577.92

    Facility

    $386.20

    $14.54 lower than Delaware for the office setting.

  • Tennessee

    Tennessee · 46270

    Office

    $547.58

    Facility

    $373.31

    $44.88 lower than Delaware for the office setting.

  • Austin

    Texas · 46270

    Office

    $620.01

    Facility

    $417.17

    $27.55 higher than Delaware for the office setting.

  • Beaumont

    Texas · 46270

    Office

    $560.95

    Facility

    $386.48

    $31.51 lower than Delaware for the office setting.

  • Brazoria

    Texas · 46270

    Office

    $590.23

    Facility

    $400.23

    $2.23 lower than Delaware for the office setting.

  • Dallas

    Texas · 46270

    Office

    $595.00

    Facility

    $404.05

    $2.54 higher than Delaware for the office setting.

  • Fort Worth

    Texas · 46270

    Office

    $591.37

    Facility

    $402.33

    $1.09 lower than Delaware for the office setting.

  • Galveston

    Texas · 46270

    Office

    $592.63

    Facility

    $402.25

    $0.17 higher than Delaware for the office setting.

  • Houston

    Texas · 46270

    Office

    $610.75

    Facility

    $420.37

    $18.29 higher than Delaware for the office setting.

  • Rest Of Texas

    Texas · 46270

    Office

    $575.94

    Facility

    $394.00

    $16.52 lower than Delaware for the office setting.

  • Utah

    Utah · 46270

    Office

    $572.12

    Facility

    $391.90

    $20.34 lower than Delaware for the office setting.

  • Virginia

    Virginia · 46270

    Office

    $583.25

    Facility

    $394.79

    $9.21 lower than Delaware for the office setting.

  • Virgin Islands

    United States Virgin Islands · 46270

    Office

    $603.86

    Facility

    $410.03

    $11.40 higher than Delaware for the office setting.

  • Vermont

    Vermont · 46270

    Office

    $579.48

    Facility

    $389.68

    $12.98 lower than Delaware for the office setting.

  • Rest Of Washington

    Washington · 46270

    Office

    $615.61

    Facility

    $413.72

    $23.15 higher than Delaware for the office setting.

  • Seattle (King Cnty)

    Washington · 46270

    Office

    $694.12

    Facility

    $458.88

    $101.66 higher than Delaware for the office setting.

  • Wisconsin

    Wisconsin · 46270

    Office

    $559.93

    Facility

    $376.26

    $32.53 lower than Delaware for the office setting.

  • West Virginia

    West Virginia · 46270

    Office

    $560.88

    Facility

    $394.28

    $31.58 lower than Delaware for the office setting.

  • Wyoming**

    Wyoming · 46270

    Office

    $591.28

    Facility

    $399.56

    $1.18 lower than Delaware for the office setting.

See how rates vary across the country

46270 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$526.53

$704.07

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$691.621
AL$534.721
AR$526.531
AZ$582.521
CA$626.29–$781.8429
CO$620.581
CT$641.331
DC$684.631
DE$592.461
FL$598.63–$667.113
GA$562.33–$613.512
GU$641.651
HI$641.651
IA$545.391
ID$549.931
IL$583.13–$645.864
IN$553.211
KS$544.461
KY$551.951
LA$551.75–$580.392
MA$617.28–$681.672
MD$603.65–$684.633
ME$554.86–$584.022
MI$568.78–$608.342
MN$588.391
MO$542.92–$580.433
MS$534.751
MT$599.811
NC$560.711
ND$580.241
NE$548.011
NH$612.411
NJ$646.90–$677.272
NM$572.791
NV$594.761
NY$569.73–$715.315
OH$564.781
OK$549.011
OR$588.43–$639.102
PA$564.73–$625.812
PR$603.861
RI$612.771
SC$564.031
SD$577.921
TN$547.581
TX$560.95–$620.018
UT$572.121
VA$583.25–$684.632
VI$603.861
VT$579.481
WA$615.61–$694.122
WI$559.931
WV$560.881
WY$591.281

Explore 46270 on the national rate map →

Where does this rate apply?

Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Delaware →

Why are the office and facility amounts different?

For 46270 in Delaware, the physician’s office rate is $592.46 and the facility-setting rate is $403.04: a difference of $189.42.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 46270 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$651.71

$592.46 × 110% = $651.71

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 46270 in Delaware.

PPRRVU2026_Oct_nonQPP.csv

5,590

Code
46270
Physician work
4.80
Practice expense
12.17
Malpractice
0.99

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office / nonfacility calculation for 46270 in Delaware
ComponentRVULocality factorAdjusted
Physician work4.80× 1.0054.8240
Practice expense12.17× 0.98812.0240
Malpractice0.99× 0.8990.8900
Total RVUs17.7380
Conversion factor× 33.4009

Office / nonfacility rate, Delaware$592.46

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 46270 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work4.81.005
Practice expense12.170.988
Malpractice0.990.899

(4.8 × 1.005 + 12.17 × 0.988 + 0.99 × 0.899) × $33.4009 = $592.46

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work4.81.005
Practice expense6.430.988
Malpractice0.990.899

(4.8 × 1.005 + 6.43 × 0.988 + 0.99 × 0.899) × $33.4009 = $403.04

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

46270 · Office / nonfacility

$592.46

Effective 2026-10-01

The base rate is $71.60 higher than on 2025-10-01, moving from $520.86 to $592.46 (13.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $520.86changed to$592.46

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.92 changed to 4.80
    • Practice expense RVU 10.30 changed to 12.17
    • Malpractice RVU 0.97 changed to 0.99
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $520.86

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$592.46$403.04RVU26D
2026-07-01$592.46$403.04RVU26C
2026-04-01$592.46$403.04RVU26B
2026-01-01$592.46$403.04RVU26A
2025-10-01$520.86$396.04RVU25D
2025-07-01$520.86$396.04RVU25C
2025-04-01$520.86$396.04RVU25B
2025-01-01$520.86$396.04RVU25A

46270 billing questions

How does 46270 differ from 46275?

46270 is for a fistula confined to subcutaneous tissue. Use 46275 when the documented tract is intersphincteric.

When is 46280 a better fit?

46280 describes treatment of a complex anal fistula. Choose based on the documented tract anatomy and complexity rather than the procedure name alone.

Can 46270 be reported with modifier 50?

No. The anatomy and service do not support bilateral adjustment, so modifier 50 is inappropriate.

What documentation supports 46270?

Document the fistula tract’s course, its depth and relationship to the sphincter muscles, and the surgical treatment performed.

Are related postoperative visits separately reported?

Related postoperative care during the 90-day global period is included, as is the day-before preoperative visit.

Can an assistant surgeon or co-surgeon be paid for 46270?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 46270PPRRVU2026_Oct_nonQPP.csv, line 5,590 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet